Tips to help produce more breast milk

The American Academy of Pediatrics recommends that babies get their nutrition exclusively from breast milk for the first six months and continue to be breastfed to supplement other foods for at least another year. According to the Centers for Disease Control and Prevention, however, only 55 percent of babies are still breastfeeding at six months of age. By the time babies celebrate their first birthday, just one-third are still breastfed.

Most moms want to breastfeed, but 6 in 10 don’t breastfeed for as long as they’d hoped. While there are a variety of reasons why women shift to using formula, including work policies and cultural norms, issues with producing enough breast milk often play a role.

Whether you have a newborn or a toddler, you may worry whether you’re producing enough milk for your child. But it’s important not to make assumptions. For example, frequent nursing, softer breasts, and unproductive pumping aren’t necessarily warning signs. On the other hand, little weight gain or infrequent wet and dirty diapers can be.

According to Kristi Gulledge, RN, MSN, a board-certified lactation consultant at UAB Medicine, new moms should expect their babies to nurse 8-10 times per day during their first month. “Oftentimes, babies cluster-feed at night,” Gulledge says. “But moms can interpret frequent feeding as low milk volume.”

She advises that newborns who have 6-8 wet diapers and 3-4 stools over a 24-hour period are getting enough milk. “After the first month, babies may poop less, but they should continue to have wet diapers,” Gulledge says.

Of course, there are times when milk production may be insufficient. Potential signs of this include when a newborn loses more weight than expected or doesn’t return to birth weight by the age of two weeks. “In addition, if an infant is in intensive care, milk production of less than 350 ml per day – about 12 ounces – may not be enough,” Gulledge says. “For an older baby who’s in daycare, the mom may be unable to pump the recommended amount.”

If you’re concerned about not producing enough milk, consider these six tips:

1. Scrap the schedule: New moms face an avalanche of well-meaning advice, but Gulledge says nursing moms should avoid admonitions to put the baby on a schedule. “A system that schedules feedings every so many hours isn’t optimal for a breastfeeding baby,” she says. “Pay attention to the baby’s signals, like putting their hands to their mouth or smacking their lips, and then feed them while they’re hungry.” A breastfed baby feeds frequently, signaling your body to step up milk production. Nursing at least once every two hours can help you produce more milk.
2. Avoid supplementing with formula: Unless your doctor recommends supplementing breastfeeding with formula, avoid doing so. Although it may be counterintuitive, supplementing with formula or other liquids may actually reduce milk production. Your body will produce enough milk to satisfy your baby; if the baby’s needs are getting satisfied with a bottle, your body will lower milk production accordingly. According to Gulledge, even if your doctor has recommended a supplement, “it doesn’t have to be a long-term solution. We can work on tips and tools to grow the supply.”
3. Check the mechanics: Bottle-feeding can create latching issues, as can nipple shields and pacifiers. If the baby isn’t gaining weight or the volume of pumping is suboptimal, “we want to make sure the baby is latching in a way that’s producing the needed amount of milk.” If a mom is pumping, Gulledge and her colleagues check to ensure that the pump is working correctly and that the mom is using it in a way that works best for her body.
4. Get enough stimulation: The big idea in milk production is to ensure that a significant amount of milk is removed frequently. That’s what signals your body to produce more. Feeding on demand helps with that process. So does expressing milk. Gulledge recommends breast stimulation 8-12 times per day. It’s also important to stimulate milk production in both breasts, so nursing your baby at least twice on each side during each feeding – called “switch nursing” – can be helpful. “Power pumping” also can increase milk production. “For one hour a day, alternate pumping for 10 minutes and resting for 10 minutes,” Gulledge says. “This extra stimulation boosts your hormones and increases milk supply.” Sometimes switching from nursing to pumping – or vice versa – can help with milk production, as can increasing the number of pumping sessions per day.
5. Relax: Many moms laugh out loud at the idea of having time to relax. Nevertheless, relaxation can help stimulate milk production. Gulledge suggests that skin-to-skin contact with your baby, relaxing music, meditation, and reading can relieve stress. “Taking slow, deep breaths while consciously relaxing your shoulders prior to nursing or pumping can also help,” she says.
6. Try lactogenic foods: While Gulledge says there is little scientific evidence about the impact of specific foods on milk production, “some moms report that eating oatmeal is helpful.” Others find that quinoa, atole (a cornmeal-based beverage), Gatorade, and lactation cookies do the trick. “There are lactation cookie recipes online that incorporate whole grains, flaxseed meal, brewer’s yeast, and chocolate chips,” she says. “Some moms eat those as a snack or as a breakfast substitute.”

Anecdotally, some moms find success with ingesting certain herbs, such as fenugreek, blessed thistle, and goat’s rue, with the latter especially helpful for moms with polycystic ovarian syndrome (PCOS) or who had limited breast tissue development during puberty. However, “Mothers who are diabetic, hypertensive, asthmatic, or who have allergies to peanuts or legumes should check with their physicians first,” Gulledge warns. “Herbs can cause allergic reactions or issues with sugar control.”

Gulledge notes that there are some factors that put mothers at risk for low milk supply. Birth control and antihistamines can be culprits, as can thyroid issues, a history of breast surgeries or breast trauma, and traumatic delivery. However, she says, “Even if a supplement is necessary, any amount of breast milk is still beneficial for the baby.”

If you’re concerned about your milk supply, UAB Medicine lactation consultants are ready to help. For women who deliver at the UAB Women & Infants Center, lactation consultants are available by appointment Monday through Friday from 8 am to 4 pm. They also offer consultations over the phone, which you can access by calling 205-975-8334. For DIY moms, Gulledge recommends lactationtraining.com, which offers printable handouts for parents.

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